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More Lives Lost Through Undiagnosed Sleep Apnoea
This article has really touched me and, although it's sad, I want to share it as a reminder to ourselves we must never drive if our treatment is going wrong and we feel sleepy, but also in the hope that others may read it and it will encourage people who suspect they may have sleep apnoea, to seek help. 3 lives have been lost through a suspected sleep apnoea sufferer falling asleep at the wheel. So sad......
A loving father fell asleep at the wheel killing himself and two members of his family on the way back from a sunshine holiday, an inquest heard today.
Stephen Padden, 56, was suspected to be suffering from a sleep disorder when he nodded off just a few miles from their Porthcawl home.
The father-of-three was driving from Gatwick Airport after a surfing holiday in Morocco when he crashed off the M4 near Cardiff.
Retired BT engineer Mr Padden was killed along with his son, Tom, 20, and partner, Louise Evans, 23.
Mr Padden’s wife Suzanne, 51, miraculously survived the crash, along with their grandson Logan, six months, who was strapped into a car seat.
Logan suffered only a minor cut to the face but was left an orphan too young to remember his mother and father.
The inquest heard the three who died were not wearing seatbelts when the Peugeot 406 hit a crash barrier on the M4 near junction 33.
Nursing manager Mrs Padden told the hearing how she had booked afternoon flights back from Morocco to avoid her husband driving late at night.
But the flight was delayed for five hours and the family landed at Gatwick at 7.45pm before setting off on the four-hour drive back to Wales.
Mrs Padden said: “As a qualified nurse, I believed that Stephen had some sort of sleep disorder.
“I booked the afternoon flight to avoid him driving at night. But because of the delay we didn’t arrive until the evening.
“I can’t be sure that made Stephen any more tired but it certainly didn’t help.”
Mrs Padden said her husband “was not himself” during the holiday and said Warfarin tablets he was taking for deep vein thrombosis were giving him flushes.
She told the inquest how they stopped for a meal and coffee on a service station en route.
She said: “I asked Stephen if he wanted me to drive but he said he was fine after the coffee.
“I fell asleep and the next thing I remember the car was rolling and there were loud bangs. It felt like a dream.
“My first reaction was for the baby but I could see he was in his car seat. To my horror no-one else was in the car.
“I was screaming. I could see that Tom was lying in the road and I could tell he was critically injured.
“Further down I could see two bodies – they were not moving and I presumed they were dead.”
She told how Mr Padden would stop breathing for 12-14 seconds at a time when he was asleep before taking a “deep breath”.
Mrs Padden said: “I kept on to him to see his doctor if there was a problem. If he went to the doctor he did not follow up any advice.”
The inquest heard the family GP said Mr Padden had not been treated for sleep disorder.
Mrs Padden was wearing a seatbelt but the other three members of her family had been thrown out of the car in the crash just before midnight on January 17 of this year.
The inquest heard 999 crews arrived to pronounce Mr Padden and Miss Evans dead. Tom Padden died the next morning in hospital.
Drivers on the M4 told how the Peugeot – with two distinctive surfboards on the roof – “zoomed” past them.
Driver Gemma Beveridge, 23, told the hearing she was worried about the way it was being driven in “spurts”, going fast, then slowing down and wavering between lanes.
She said: “I was not sure if it was boy racers or if the driver had fallen asleep at the wheel.
“I remember thinking what on earth was he doing. I saw him hit the barrier and there were sparks as the car went up in the air.”
Miss Beveridge stopped to help and was handed six-month-old baby Logan by distraught Mrs Padden at the roadside.
Pc Philip Painting, who investigated the crash, said: “If they had their seatbelts on they would have remained in the vehicle and their injuries would have been significantly reduced.”
The surfing-mad family, of Porthcawl, had been on a week’s holiday to Morocco.
Tom Padden was a former Welsh junior surfing champion and hoped to make a living out of it.
The family had posed for happy family photographs with Logan shortly before they flew home.
Cardiff coroner Mary Hassell said: “Stephen’s driving was erratic. He was braking and speeding up. He didn’t apply the brakes at the time of the accident.
“It seems to me extremely likely that Stephen fell asleep at the wheel and then, to compound that, they were not wearing their seatbelts.”
She recorded three verdicts of accidental death.
A statement from the family said: “Louise, Thomas and Stephen passed away as a result of a tragic accident. Their death has left a huge void in the lives of so many, it has left a young child without parents and grandfather.
“All family members would like to thank everyone for their support.
“Tom had taken to being a father as he did everything else in life, without fear and with total conviction.
“He had been a wonderful father and we watched him become a man.
“He was devoted to Louise and their baby son, Logan, who would spend hours watching him surfing.
“Louise was the perfect match for Tom and would have been a wonderful mother. For a couple so young they were remarkable parents.”
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Replies to This Discussion
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Permalink Reply by RockRpsgt on
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Richard,
I would like to talk more on your statements regarding "size vs fitness". I believe that it depends on the person. I truly believe that just being over 6' tall increases your chances for apnea or disease. Thinking back on it I do not believe that I have ever had a negative reading for apnea on anyone over 6 foot 2 inches.
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Permalink Reply by Kath Hope on
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This is interesting Rock.
Rock said:
Richard,
I would like to talk more on your statements regarding "size vs fitness". I believe that it depends on the person. I truly believe that just being over 6' tall increases your chances for apnea or disease. Thinking back on it I do not believe that I have ever had a negative reading for apnea on anyone over 6 foot 2 inches.
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We appreciate your posts Rock in educating us, and are happy to put up with your scrambled thoughts whilst you're working ;)
The wife of the driver was on tv here yesterday (which was brave of her so early after the tragic accident) and was pleading with people to wear their seatbelts. The son and his partner didn't have theirs on as they'd fallen asleep in the car park of a motorway service station, where they'd stopped for a toilet break and to refresh the driver. She didn't mention why the driver didn't have his on, but said he normally did. I was disappointed the tv show didn't focus more on the fact that he was driving whilst sleep deprived, irrespective of whether he had apnoea or not! The little baby is being cared for by the grandparents and relatives - poor little mite!
Rock said:Interesting discussion guys. We always seem to come back to the chicken or the egg theory. I would like to add some things. Please excuse my scrambled thoughts as I am working and will be adding throughout the night......................................................................
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Permalink Reply by Richard Mundy on
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Hi Rock,
Scrambled thoughts? Chicken and egg? What's for breakfast?!
Sleep Apnoea can derive from a number of pre-existing physical conditions whereas OSA is from just one: the repeated interruption to the passage of air into the lungs. Central Sleep Apnoea is more of a neurological disorder OSA is commonly found with obese patients. I have a BMI of 25, so I do not have OSA, but I don't have Central Sleep Apnoea either. Let me explain, you may find it interesting.
Many years ago when I was in my late teens (I am now 66) I caught TB and developed Tubercular Pericarditis. This resulted in the surgical removal of the pericardium; this is the skin that holds the heart together; mine had become calcified and thick, more like the skin of a Jaffa orange rather than that of a sausage, which is what it should have been. I continued with the medication for TB: PAS cachets and daily injections of Streptomycin for over six months.
I had never been keen on playing sports, so there were few sacrifices. I could walk distances without trouble and the TB and heart problem did not make a significant impact on my life.
In the late 60s I developed Iritis in my left eye, a classic early indicator of the likely onset of Ankylosing Spondilitis, a fusing of the vertebrae in the spinal column. This can take on varying degrees of severity, I was fortunate that mine was not disabling, although, with the passage of time, my rib-cage has become restricting in that its capacity to expand has become very limited.
I have never been a snorer, however, in the early 90s my wife said to me on a number of occasions ‘Do you know you stop breathing when you’re asleep?’ My reply was probably on the lines of ‘Don’t be so silly. If I had stopped breathing I would be dead by now.’ I had a lung function test at the local hospital and it was thought I might have very mild sleep apnoea. But this was not expanded upon or followed up.
Fast forward to the late 90s and I begin to feel seriously unwell. An echocardiogram shows evidence of a leaky mitral valve, but no mention of Sleep Apnoea. I now take Perindopril and Frusemide, a very common medication for people in their late fifties.
It’s a very busy, active life running my own business, but by 2003/4, I begin to falter again. The heart specialist tells me it’s the leaky valve, and it’s nothing to worry about. Just take it easy – easier said than done, I’m afraid.
I would wake in the morning with a horrid, throbbing headache, not wanting to face the day ahead. I would speak to people on the phone and immediately I put the phone down I would have forgotten what had been said. This went on for months until I lost my temper with the specialist: ‘if it’s only a leaky valve and nothing to worry about, why do I feel so dreadful?’ I was immediately referred to a respiratory consultant.
Within 3 weeks I had had any number of tests and an overnight polysomnogram and now had a clear diagnosis of what was wrong: Pulmonary Hypertension and Sleep Apnoea. The TB had left me with about 30% lung-capacity and the Pulmonary Artery was having difficulty delivering de-oxygenated blood to the lungs. I was having apnoeas 25 times an hour and my blood-sats were down to 82%. And Pulmonary Hypertension is a life-limiting condition.
I don’t have a CPAP, but a BREAS PV409 PEEP ventilator (Steve Reeves ‘Superman’ used the same model) which I use every night plus oxygen 16/24hrs. The ventilator delivers 30-35 mmH2O and ensures the blood-sats never dip below 91% during the night.
The TB resulted in the pericardectomy and damaged lungs and led to the leaky heart-valve, the AS caused the rigid rib-cage and restriction of breathing; the leaky valve, led to the constriction of the pulmonary artery and the damaged lungs prevented proper perfusion of O2 and all combined to produce sleep apnoea!
This is more ‘Daisy Chain’ than chicken and egg.
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Permalink Reply by Julie on
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Hi Richard, thanks for the explanation. I've obviously misinterpreted what you meant. There's just a misconception that only overweight people can suffer with sleep apnoea. I'd be interested to know how many people on this forum have OSA and who are not overweight.
Julie
Richard Mundy said:Hi Julie,
I'm sorry if I didn't make myself clear; of course, people of all builds can develop sleep apnoea. It is not restricted to those who are overweight. Of those who are overweight and do develop sleep apnoea, however, there is a greater chance of developing Obstructive Sleep Apnoea rather than any other type. It also follows that obesity does not necessarily result in sleep apnoea
Furthermore, as a way of relating a person's 'size' to their 'fitness', the Body Mass Index (BMI) is a poor indicator since it fails to differentiate between body-fat and muscle-mass. Two men may have identical BMIs; one is a long-term couch-potato who shudders at the thought of exercise, the other works-out regularly in the gym, runs and plays sports, yet according to their BMI they are both obese, but do they both have a limited future life-span?
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Richard,
I love breakfast! My schedule allows me to eat it for dinner most nights.
Pulmonary Hypertension and TB are gamechangers. I appreciate your participation in my continued education.
Yes I am a little confused. Not obstructive or central apnea is where you got me. What do you call it? I understand the pre-esxisting chain of condiditions. However one of them has to be the source. It's either the obstructed or a communication problem. Knowing the source could go along way in assisting those in your situation.
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Permalink Reply by Tigers Fan on
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Kath Hope said:This is interesting Rock.
Rock said:Richard,
I would like to talk more on your statements regarding "size vs fitness". I believe that it depends on the person. I truly believe that just being over 6' tall increases your chances for apnea or disease. Thinking back on it I do not believe that I have ever had a negative reading for apnea on anyone over 6 foot 2 inches.
You say being over 6' tall (I am) increases chances of apnoea or disease and go on to say you do not believe you have ever had a negative reading for apnoea for anyone over 6' 2" (I am).
I guess it depends on what you mean by a 'negative reading' but I understand you to be saying under 6' and over 6'2" tall is relatively safe but between the two is highly dangerous. Is that what you mean?
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Sorry TF after re-reading my post I can see how it might be confusing. We talk about BMI and apnea all of the time. I think that overall size plays a role in are health as well. I believe that just having a large frame might cause some problems. I have many patients over 6'2". Thinking back I do not believe that any of them have ever not had apnea regardless of their BMI.
A negative reading would be no apnea.
Tigers Fan said:
Kath Hope said:This is interesting Rock.
Rock said:Richard,
I would like to talk more on your statements regarding "size vs fitness". I believe that it depends on the person. I truly believe that just being over 6' tall increases your chances for apnea or disease. Thinking back on it I do not believe that I have ever had a negative reading for apnea on anyone over 6 foot 2 inches.
You say being over 6' tall (I am) increases chances of apnoea or disease and go on to say you do not believe you have ever had a negative reading for apnoea for anyone over 6' 2" (I am).
I guess it depends on what you mean by a 'negative reading' but I understand you to be saying under 6' and over 6'2" tall is relatively safe but between the two is highly dangerous. Is that what you mean?
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I'm just posting a link to a radio interview with Jeremy Vine which took place today, where a truck driver caused a fatal accident through undiagnosed sleep apnoea. The driver and the father of the boy who was killed are both interviewed. Be quick though, as I reckon this link won't last long as it's on the BBC website. You will need to fast forward the player to 1hour + 37 minutes. The interview takes place, then there's a little break + it then continues. http://bbc.in/q2YMMO
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Permalink Reply by suzanne padden on
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im not sure what to say in reply to this article but it was my family that was in the accident. i had worried for years about his sleep apnoea but steve didnt really belive he was putting his life and his famalies at risk. so he never went for that apointment.
it was funny but tom also had problems even as a small child he would hold his breath for long periods when sleeping.
i just wish i had stayed awake myself or at least insisted on driving.
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Oh Suzanne, I cannot tell you how I feel for you. I have tears now in my eyes as I'm typing. I am so pleased you've found us, as it gives me a chance to say to you personally (and in fact have already said on Facebook to others) what a brave lady you are, and in more ways than I even realize. I saw you on the morning tv show and to do that so fresh after your dreadful tragedy humbled me. I know that nothing I say can alter things, but if it's at all possible, please try not to take the responsibility on your own shoulders as there's absolutely no way you could have known what was going to happen that dreadful day. I posted this discussion here, in the hope that others who suspect they may have sleep apnoea would see it and take action, so if it's any small comfort at all to you, other lives can be saved through this.
Thankfully, little Logan's life was spared, and I'm sure he's bringing much joy to your lives. Just one thing I would say is that you observe him, just in case the suspected sleep apnoea in your family is genetic (with you saying Tom also showed signs of sleep problems).My deepest thoughts are with you Suzanne and thanks for yet another sign of your bravery by joining us on here.
Best Wishes!
Kath
suzanne padden said:im not sure what to say in reply to this article but it was my family that was in the accidnet. i had worried for years about his sleep
apnoea but steve didnt really belive he was putting his life and his famalies at risk. so he never went for that apointment.
it was funny but tom also had probelms even as a small child he would hold his breath for long periods when sleeping.
i just wish i had stayed awake myself or at least insistedon driving.
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It is very kind of you to post your thoughts here, Suzanne.
Reaching a diagnosis of Sleep Apnoea is not as simple as you might think, there are a number of issues that get in the way. For someone earning their living by driving, they would be naturally reluctant to own up to feeling sleepy at the wheel, because, if they did, they would most likely lose their driving-licence and their job. Their employer wouldn't raise the question of SA with his drivers, either, because he doesn't want to have to fork out for NHS screening of his fleet. And if the driver does go and see his GP there's a strong chance the GP will not recognise SA and simply tell the patient to 'Go away and lose some weight, come back in six months time.'
That's not all, believe it or not, the average length of time between first visiting his GP to complain of daytime tiredness and getting diagnosed by a respiratory/sleep consultant is around two years. That's before any treatment has begun; and in that time, most blokes would have given up, or had a fatal accident - and that is where the problem lies.
I am beginning a campaign to address all these issues, I have some big guns in support, and I would be delighted if you could join me. The website is almost finished, please go to www.truckershealthuk.wordpress.com and www.facebook.com/truckershealth for a better idea of what it's all about. You can find me at contact@truckershealth.org.uk, I would be delighted to hear from you.
If you make a note of the web address and give it to anyone you meet that has a daytime sleep problem, you can be helping to breaking down the barriers that surround this dreadful disorder.
Best wishes
Richard
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